✦ ANAL FISTULA · GOLD STANDARD

Fistulotomy

Q: Will fistulotomy affect my bowel control?

For simple low fistulas with minimal sphincter involvement, the risk of significant incontinence is less than 2%. Pre-operative MRI confirms the tract's relationship to the sphincter muscles.

Q: How many procedures will I need for an anal fistula?

Simple low fistulas are treated in one fistulotomy procedure. Complex high fistulas require staged treatment with seton drainage first.

Q: How long does the fistulotomy wound take to heal?

The open wound heals by secondary intention over 4–6 weeks. Regular sitz baths twice daily and wound assessment at 2 and 6 weeks ensure normal healing progress.

Gold standard laying open of the anal fistula tract — over 95% cure rate for simple low fistulas.

30–60 Min TREATMENT DURATION

Day Care CARE SETTING

Surgical APPROACH

1–2 Weeks RECOVERY TIMELINE

What is Fistulotomy?

Fistulotomy (laying open) is the gold standard surgical treatment for simple low anal fistulas. The skin and tissue overlying the fistula tract are divided with a surgical probe, converting the closed infected tunnel into an open groove that heals from the base by secondary intention. Dr. Tagore Mohan Grandhi performs fistulotomy under day surgery anaesthesia. Pre-operative MRI confirms minimal sphincter involvement before fistulotomy is performed, ensuring the low risk of incontinence is maintained.

Suitable for patients with simple low anal fistulas — intersphincteric or low transsphincteric — where pre-operative MRI confirms minimal sphincter muscle involvement making fistulotomy safe.

How the Procedure Works

MRI Assessment

MRI pelvis confirms simple low fistula and sphincter relationship. Examination under anaesthesia (EUA) provides tactile confirmation.

Probe Placement

Malleable probe passed from external to internal opening, delineating the entire course of the fistula tract.

Tract Division

Tissue overlying the probe — skin, subcutaneous tissue, and minimal sphincter fibres — divided with diathermy, opening the tract.

Wound Curettage

Open wound curetted. Wound left open to heal from the base upward by secondary intention.

Wound Healing

Regular sitz baths and wound care over 4–6 weeks to achieve complete healing. Review at 2 and 6 weeks.

Outcomes

30–60 MinTREATMENT DURATION

Day CareCARE SETTING

SurgicalAPPROACH

1–2 WeeksRECOVERY TIMELINE

Who Needs This Treatment?

→Over 95% cure rate — highest of any anal fistula procedure
→Simple day surgery — no implants, no endoscopes, no complex reconstruction
→Immediate resolution of pain, discharge, and recurrent abscess episodes
→Well-established technique with an extensive long-term safety record

Fistulotomy is one of the most satisfying operations in anorectal surgery. A single 30-minute day procedure ends months or years of pain, discharge, and recurrent abscesses — with a 95%+ cure rate.

— Dr. Tagore Mohan Grandhi, Senior Consultant Gastrointestinal Surgeon, Lux Hospitals, Hyderabad

Common Questions

Frequently Asked Questions

Will fistulotomy affect my bowel control?+

How many procedures will I need for an anal fistula?+

How long does the fistulotomy wound take to heal?+

Not sure which treatment is right for you?

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